This Monday I offered to be in wound care which ended up being a great relief. While my friends were unfortunately busy getting yelled at by my clinical teacher I was busy observing procedures regarding various wounds. I didn't see anything out the ordinary, just a few pressure ulcers and g-tube dressings, until I walked into a patient's room who had two massive hernias in his abdomen. These alleged hernias were very tumor-like in appearance, it was as if this patient was a bilateral below-the-knee amputee, although both his legs sat clearly underneath his protruding trunk. It was pretty gruesome, he didn't seem to be in any apparent distress and he denied any pain, but it looked awful. His insides were stretching his skin out so much he had skin tears as a result of it. The nurse who we, my friend Lynne and I, were shadowing was not very willing to have us participate in the treatment other than assisting in repositioning the patients. That was a big bummer. Meanwhile, Lynne and I had no idea that the second day of med-pass was an apparent disaster. Classmates were making med-errors left and right and my teacher was very unhappy. At the end of the day she discussed her frustrations and gave us the option to go home and be prepared to pass meds in the morning or to wake up and not pass meds at all. The latter clearly would have been detrimental to our clinical experience, espeically because we should be focusing on prioritizing passing medications into our day-to-day patient care. On Tuesday I knew I would be on the floor and was dreading even getting out of my bed; I was terrified. After being convinced by my carpool, I dragged myself out of bed and tried to remain calm. After being given my assignment I quickly went into the room and obtained her vital signs and did a quick head-to-toe assessment. I soon discovered my patient was a fifty-one year old woman addicted to heroin living on the streets, I knew it would be quite the interesting day. After grabbing her MAR (medication administration record) I discovered her twelve medications to be administered at 0900. I knew that the sooner I grabbed information (including the dosage, reason for taking them, and side effects of each individual drug) the happier my instructor would be. I rushed to grab my drug guide and quickly jotted down a few important notes, making sure to cross reference her lab results to make sure it would be safe to administer them to her. Other than overdosing she came in for chronic obstructive pulmonary disease, pneumonia, horrible wounds on her feet, and a urinary tract infection. I triple checked all my math and appropriate meds before asking my teacher to grab her narcotic medication and to come with me to administer them. I was ecstatic after realizing I had answered all her questions correctly without making any medication error. After checking my patient's information, I made sure each drug was actually completely swallowed (being especially careful with her narcotic medication methadone). I then continued on with my day and was able to give my first real-life injection which happened to be a drug that stimulated the patient's red blood cell formation and I gave it to him in his tummy. After giving the first subcutaneous injection I felt a lot more comfortable and confident. I am actually becoming a nurse!!! It is so exciting, I was also able to test my patient's blood sugar and instead of informing her nurse she needed to have insulin coverage I was sure to check her sliding scale and administer her regular insulin with yet another subcutaneous injection all by myself! Overall, I had a great day but where has the time gone?! I have many, many, more things to do! Enjoy your night and thanks for reading.
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